President Barack Obama told an audience of media professionals Tuesday that the only two ways to cover individuals with pre-existing conditions are via the individual mandate in his health care reform law or a single-payer health insurance system.

Following his keynote address at the Associated Press Annual luncheon held during the Newspaper Association of America conference in Washington, D.C., Obama was asked, “If the court were to overturn individual mandate, what would you do or propose to do for the 30 million people who wouldn’t have health care after that ruling?”

He responded, “The point I think that was made very ably before the Supreme Court, but I think most health care economists who have looked at this have acknowledged, is there are basically two ways to cover people with pre-existing conditions or assure that people can always get coverage even when they have bad illnesses.”

Obama continued, “One way is a single-payer plan. Everybody is a under a single system, like Medicare. The other way is to set up a system in which you don’t have people who are healthy but don’t bother to get health insurance, and then we all have to pay for them in the emergency room. That doesn’t work, and so as a consequence, we’ve got to make sure that those folks are taking their responsibility seriously, which is what the individual mandate does.”

The president predicted that the Supreme Court would uphold the individual mandate, which requires Americans to purchase health insurance or pay a fine to the IRS.

“I don’t anticipate the court striking this down. I think they take their responsibilities very seriously,” he said.

In the question and answer session, Obama directly addressed the Republican presidential primary.

“There is a reason why there’s a little bit of confusion in the Republican primary about health care and the individual mandate, since it originated as a conservative idea to preserve the private marketplace in health care while still assuring that everybody got coverage, in contrast to a single-payer plan. Now suddenly this is some socialist overreach,” he said.